Riza (not his real name) has had type-2 diabetes for a few years now. Recently, he has been experiencing numbness that comes and goes in his left foot, primarily in his toes, after which he feels some stiffening in the centre of his foot, right behind the digits.

Riza says it’s best to check one’s feet every day and see a doctor if there’s a cut or blister that won’t heal. He monitors his sugar daily and has been to the podiatrist several times.

His late father, who was also a diabetic, had had his leg amputated when he was in his 60s. Riza has bad memories of seeing his father suffering from being immobile and in constant pain.

About half of people with diabetes have some kind of nerve damage. Although this can happen in any part of the body, the nerves in the feet and legs are most often affected, resulting in loss of sensation in the extremities.

Nerve damage can cause numbness, tingling or pain, as well as lower one’s ability to feel pain, heat or cold. If you don’t feel pain, you might not notice a cut, blister, sore, or other problem. Small problems can become serious if they aren’t treated early.

Some people, however, might not have any symptoms whatsoever. These are the factors that can increase the risk of nerve damage:

• hard-to-manage blood sugar levels;
• elevated blood sugar levels;
• being overweight;
• being older than 40 years;
• having high blood pressure; and
• having high cholesterol.

Nerve damage, along with poor blood flow, puts one at risk of developing a foot ulcer that could get infected and not heal well. If the infection doesn’t get better, the toe, foot, or part of the leg might need to be amputated to prevent the infection from spreading, and to save the patient’s life.

Early treatment greatly reduces one’s risk of amputation. Here are some steps to ensure the health of your feet:

• Check your feet every day for cuts, redness, swelling, sores, blisters, corns, calluses, or any other change to the skin or nails.
• If it’s difficult, use a mirror to see the bottom of the feet, or ask a family member to help.
• Wash your feet every day in warm water, but don’t soak them. Dry them completely and apply lotion to the tops and soles but not between the toes, which could lead to infection.
• Never go barefoot. Always wear shoes and socks or slippers, even inside, to avoid injury. Check that there aren’t any pebbles or other objects inside the shoes, and that the lining is smooth.
• Trim toenails straight across and gently smooth any sharp edges with a nail file.
• Don’t remove corns or calluses by yourself, and don’t use over-the-counter products to remove them as these could burn the skin.
• Get your feet checked at every healthcare visit. Also, visit the podiatrist yearly for a complete exam, which includes checking for feeling and blood flow.
• Put one’s feet up when sitting, and wiggle the toes for a few minutes several times throughout the day.
• Choose foot-friendly activities like walking, riding a bike or swimming. Check with your doctor on activities that are best for you and which to avoid.

Riza says if one experiences any of the following symptoms, don’t wait for the next appointment – see your doctor right away:

• pain in the legs or cramping in the buttocks, thighs, or calves during physical activity;
  tingling, burning, or pain in the feet;
• loss of sense of touch or ability to feel heat or cold very well;
• change in the shape of one’s feet over time;
• loss of hair on the toes, feet, and lower legs;
• dry, cracked skin on the feet;
• change in the colour and temperature of the feet;
• thickened, yellow toenails;
• fungal infections such as athlete’s foot between the toes;
• blisters, sores, ulcers, infected corns, or ingrown toenails.

Most people with diabetes can prevent serious foot complications such as ulcers and amputation through regular home care and keeping doctor’s appointments.

TELEME Healing Life Stories is a collection of inspirational stories of how ordinary people triumph over their health conditions and recover to lead a healthier life. Email [email protected] to share your story.

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